Complexity perspectives on clinical decision making in an intensive care unit

被引:14
|
作者
de Bock, Ben A. [1 ,2 ]
Willems, Dick L. [3 ]
Weinstein, Henry C. [4 ,5 ]
机构
[1] Univ Amsterdam, Acad Med Ctr, Dept Gen Practice, Amsterdam, Netherlands
[2] Univ Amsterdam, Acad Med Ctr, Dept Gen Practice, Med Eth, Amsterdam, Netherlands
[3] Univ Amsterdam, Sect Med Eth, Dept Gen Practice, Med Eth, Amsterdam, Netherlands
[4] Vrije Univ Amsterdam, Alzheimer Ctr, Amsterdam, Netherlands
[5] OLVG Hosp, Dept Neurol, Amsterdam, Netherlands
关键词
clinical decisions; complexity science; emergence; intensive care unit; qualitative empirical research; transdisciplinarity;
D O I
10.1111/jep.12794
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Rationale, aims, and objectivesHow to clarify the implications of complexity thinking for decision making in the intensive care unit (ICU)? MethodRetrospective qualitative empirical research. Practitioners in an ICU were interviewed on how their decisions were made regarding a particular patient in a difficult, clinical situation. Transcriptions of these interviews were coded and retrieved in Maxqda, a software program. Assisted by complexity thinking, researchers focused on the decision-making process and the shift from analytic approaches to complex approaches. ResultsOriginally, practitioners took their decisions with negligible transdisciplinary interactivity, drawing on analytical knowledge. Later on, they shifted to transdisciplinary practices, paying attention to more participation in their decision-making processes within their complex environment. ConclusionsComplexity thinking demonstrates that this is a better model towards understanding transdisciplinary decision making then most analytical methodologies.
引用
收藏
页码:308 / 313
页数:6
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